Wanted: Midwives for 48 Million Women

About 1.3 million babies could be saved each year if only the global shortage of 350,000 midwives would be filled, a new report of Save the Children says.

One in three mothers, about 48 million women, gives birth every year without a trained medical worker present. About two million women deliver their babies completely alone, the report says.

My mother works as a midwife in a rural town in southern Philippines. Growing up, I saw first-hand how the shortage of health workers could put women’s and babies’ lives in danger. In mountainous areas which can only be reached by hours of walking, deliveries are often handled by traditional birth attendants who follow superstitious rituals rather than proper medical practice.

Some attendants wait until low tide before delivering the baby since they believe this is the proper timing to give birth. Others put a cockroach leg in the newborn’s mouth supposedly to protect her from evil spirits. They also don’t have the proper tools for safe delivery. An unsterilized blade or pair of scissors is often used to cut the umbilical cord, which exposes the baby to tetanus.

To address this problem, the local health unit conducted trainings on proper delivery for these traditional birth attendants. After all, they can’t just be banned from practicing their trade; they are usually trusted women in their communities. The measly budget of the local government also cannot support the hiring of additional midwives.

Difficult working conditions – a lot of health workers in developing countries are overworked, underpaid and lack the equipment and supplies they need for them to do their job.

Disparities in health coverage – workers in search of better opportunities leave the rural areas to work in cities.

Migration of health professionals – the lure of higher salaries in rich countries have led to a massive brain drain in the medical field in developing countries.

Lack of education and training – many poor countries don’t have adequate facilities and personnel to train enough number of health workers that will meet the needs of the population.

Chronic under-investment in human resources – funding for human resources development of the health sector hasn’t been a high priority among donor agencies and global health initiatives.

It still amazes me how my mother managed to stay in her job in the same godforsaken town for almost 30 years. She receives a monthly salary of about $360.

In her previous assignment which lasted for about 18 years, she had to ride on top of a cargo truck for two hours and cross 13 rivers to get to the health center. The village had no running water and no electricity, which made vaccine storage a huge challenge. Medicines were (and still are) always in short supply.

On immunization day, she vaccinates about 200 babies, conducts prenatal checkups on almost 100 women, and attends to whatever aches and pains of other patients. All of these in one day.

She’s about to retire next year, along with three of her colleagues. Fortunately, the local government has already hired new midwifes to replace them. Unfortunately, the new ones will still have to contend with the same challenges they faced.